Erythromycin stearate, 1.5 g, for the oral prophylaxis of streptococcal bacteraemia in patients undergoing dental extraction: efficacy and tolerance

Abstract

Erythromycin stearate, 1.5 g, was effective in reducing the prevalence of streptococcal bacteraemia following dental extraction when administered orally under supervision 1 h before extraction. Blood samples were collected from adult patients for culture and erythromycin assay 1 to 2 min after the dental procedure. High dilution techniques involving the use of 1 litre bottles of broth were used to inactivate erythromycin present in blood cultures. Viridans streptococci were isolated from 6 of 40 patients receiving erythromycin (15%) compared with 18 of 42 control patients (43%). The mean serum erythromycin concentration at the time of extraction was 3.7 mg/l for 34 patients receiving erythromycin who had negative blood cultures compared with 1.8 mg/l for the six patients given erythromycin who had viridans streptococci isolated from the blood. Both the 1.5 g erythromycin stearate and placebo oral doses were well tolerated in a double blind comparative study which included 109 adult dental patients.